DataSheet_1_Association Between Air Pollution and the Risk of Uveitis: A Nationwide, Population-Based Cohort Study.docx

Previous studies have revealed an association between ocular surface disorders and air pollution, few studies have focused on the risk of uveitis. We aimed to investigate whether air pollution increases the risk of uveitis. We used the Taiwan Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality Monitoring Database (TAQMD) to conduct a retrospective cohort study. Air pollutant concentrations, including those of carbon dioxide (CO2), were grouped into four levels according to quartiles. The outcome was the incidence of uveitis, as defined in the International Classification of Diseases, Ninth Revision. We used univariable and multivariable Cox proportional hazard regression models to calculate the adjusted hazard ratios (aHRs) and determine the potential risk factors of uveitis. Overall, 175,489 subjects were linked to their nearby air quality monitoring stations. We found that for carbon monoxide, the aHRs of uveitis risk for the Q3 and Q4 levels were 1.41 (95% confidence interval (CI) = 1.23–1.61) and 2.19 (95% CI = 1.93–2.47), respectively, in comparison with those for the Q1 level. For nitric oxide, the aHRs for the Q3 and Q4 levels were 1.46 (95% CI = 1.27–1.67) and 2.05 (95% CI = 1.81–2.32), respectively. For nitrogen oxide (NOx), the aHRs for the Q2, Q3, and Q4 levels were 1.27 (95% CI = 1.11–1.44), 1.34 (95% CI = 1.16–1.53), and 1.85 (95% CI = 1.63–2.09), respectively. For total hydrocarbon (THC), the aHRs for the Q2, Q3, and Q4 levels were 1.42 (95% CI = 1.15–1.75), 3.80 (95% CI = 3.16–4.57), and 5.02 (95% CI = 4.19–6.02), respectively. For methane (CH4), the aHRs for the Q3 and Q4 levels were 1.94 (95% CI = 1.60–2.34) and 7.14 (95% CI = 6.01–8.48), respectively. In conclusion, air pollution was significantly associated with incidental uveitis, especially at high THC and CH4 levels. Furthermore, the uveitis risk appeared to increase with increasing NOx and THC levels.

既往研究已证实眼表疾病（ocular surface disorders）与空气污染存在相关性，但目前鲜有研究聚焦于葡萄膜炎（uveitis）的发病风险。本研究旨在探讨空气污染是否会升高葡萄膜炎的发病风险。本研究依托台湾纵向健康保险数据库（Taiwan Longitudinal Health Insurance Database, LHID）与台湾空气质量监测数据库（Taiwan Air Quality Monitoring Database, TAQMD）开展一项回顾性队列研究（retrospective cohort study）。研究将包括二氧化碳（carbon dioxide, CO₂）在内的空气污染物浓度按四分位数划分为四个暴露等级。本研究的结局指标为按《国际疾病分类第九版》（International Classification of Diseases, Ninth Revision）定义的葡萄膜炎发病率。我们采用单因素及多因素Cox比例风险回归模型（Cox proportional hazard regression models）计算校正后风险比（adjusted hazard ratios, aHRs），并分析葡萄膜炎的潜在危险因素。最终共有175489名研究对象与周边空气质量监测站点完成数据匹配。结果显示，以Q1暴露等级为参照，一氧化碳Q3、Q4等级对应的葡萄膜炎发病风险校正后风险比分别为1.41（95%置信区间（confidence interval, CI）=1.23~1.61）与2.19（95% CI=1.93~2.47）。一氧化氮Q3、Q4等级对应的aHRs分别为1.46（95% CI=1.27~1.67）与2.05（95% CI=1.81~2.32）。氮氧化物（nitrogen oxide, NOₓ）Q2、Q3、Q4等级对应的aHRs分别为1.27（95% CI=1.11~1.44）、1.34（95% CI=1.16~1.53）与1.85（95% CI=1.63~2.09）。总烃（total hydrocarbon, THC）Q2、Q3、Q4等级对应的aHRs分别为1.42（95% CI=1.15~1.75）、3.80（95% CI=3.16~4.57）与5.02（95% CI=4.19~6.02）。甲烷（methane, CH₄）Q3、Q4等级对应的aHRs分别为1.94（95% CI=1.60~2.34）与7.14（95% CI=6.01~8.48）。综上，空气污染与偶发性葡萄膜炎存在显著相关性，尤其当总烃与甲烷浓度处于较高水平时关联更为突出。此外，葡萄膜炎的发病风险随氮氧化物与总烃浓度升高呈显著递增趋势。